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Two-Year Outcomes After Primary Anatomic Coracoclavicular Ligament Reconstruction
Peter J Millett1, Marilee P Horan2, Ryan J Warth2
1Center for Outcomes-based Orthopaedic Research, Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; The Steadman Clinic, Vail, Colorado, U.S.A..
Summary
Anatomic coracoclavicular ligament reconstruction (ACCR) using allografts shows good outcomes for severe AC joint dislocations. Patients experienced improved function and satisfaction, though complication risks warrant further study.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Musculoskeletal Research
Background:
- Acromioclavicular (AC) joint dislocations, particularly high-grade injuries (Rockwood grade III and V), present significant challenges in shoulder function.
- Anatomic coracoclavicular ligament reconstruction (ACCR) is a surgical option to restore stability.
- Free tendon allografts are utilized in ACCR, but outcomes require detailed reporting.
Purpose of the Study:
- To evaluate clinical and structural outcomes of anatomic coracoclavicular ligament reconstruction (ACCR) using free tendon allografts.
- To assess outcomes in patients with Rockwood grade III and V acromioclavicular (AC) joint dislocations.
Main Methods:
- A case series of 31 patients undergoing primary ACCR with tendon allografts for AC joint dislocations.
- Preoperative and postoperative outcome measures included ASES, SF-12 PCS, pain scales, QuickDASH, SANE scores, and patient satisfaction.
- Radiographic analysis of coracoclavicular distances was performed.
Main Results:
- 31 patients (mean age 43.9 years) underwent ACCR.
- Complications occurred in 7 patients (22.6%), necessitating further surgery.
- Among 24 patients without revision, significant improvements were observed in ASES (58.9 to 93.8) and SF-12 PCS (45.3 to 54.4) scores (P < .001 and P = .007, respectively).
- Final SANE and QuickDASH scores were 89.1 and 5.6, with a median patient satisfaction of 9/10.
Conclusions:
- ACCR with allografts can yield excellent functional outcomes and high patient satisfaction in selected patients.
- The complication rate necessitates further investigation into ACCR techniques to minimize risks.
- Future research should aim to refine ACCR methods for improved stability and reduced complications.
